Abstract
ObjectiveTo compare the long-term survival of colorectal cancer (CRC) in young patients with elderly ones.MethodsUsing Surveillance, Epidemiology, and End Results (SEER) population-based data, we identified 69,835 patients with non-metastatic colorectal cancer diagnosed between January 1, 1988 and December 31, 2003 treated with surgery. Patients were divided into young (40 years and under) and elderly groups (over 40 years of age). Five-year cancer specific survival data were obtained. Kaplan-Meier methods were adopted and multivariable Cox regression models were built for the analysis of long-term survival outcomes and risk factors.ResultsYoung patients showed significantly higher pathological grading (p<0.001), more cases of mucinous and signet-ring histological type (p<0.001), later AJCC stage (p<0.001), more lymph nodes (≥12 nodes) dissected (p<0.001) and higher metastatic lymph node ratio (p<0.001). The 5-year colorectal cancer specific survival rates were 78.6% in young group and 75.3% in elderly group, which had significant difference in both univariate and multivariate analysis (P<0.001). Further analysis showed this significant difference only existed in stage II and III patients.ConclusionsCompared with elderly patients, young patients with colorectal cancer treated with surgery appear to have unique characteristics and a higher cancer specific survival rate although they presented with higher proportions of unfavorable biological behavior as well as advanced stage disease.
Highlights
Colorectal cancer (CRC) is one of the most common malignancies and is ranked as the third leading cause of cancerrelated deaths in the USA [1]
Patient Characteristics We identified 69,835 eligible patients with CRC in SEER
Clinicopathological Differences between the Two Groups When compared to elderly patients, in group of young ones, it was investigated that significant differences were found among the years of diagnosis (more frequent in recent years(2000–2003), P, 0.001), race, pathological grading, histological type, American Joint Committee on Cancer (AJCC) stage, No of LNs dissected and LNR(more rN1, p, 0.001)
Summary
Colorectal cancer (CRC) is one of the most common malignancies and is ranked as the third leading cause of cancerrelated deaths in the USA [1]. The incidence of CRC in Asian countries is increasing rapidly and has been considered to be similar to that of the Western countries [2,3]. CRC is thought to be a malignancy affecting mostly on the elderly persons, with more than 90% of patients being diagnosed after age 55 years [4]. The 2010 Annual Report to the Nation on Cancer celebrated a steady decline in the incidence of CRC in USA [5]. The incidence of the disease, considering patients aged between 20–40 years of age increased by 17% during the period between 1973 and 1999 [7]
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